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Reccurrent KCOT in Right Maxillary Sinus
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Reccurrent KCOT in Right Maxillary Sinus

Hello,

     I am a 17 year old male entering my senior year in high school. I have had two surgeries, in April and December of 2007, to remove an inflamed keratocystic odontogenic tumor (KCOT) in my right posterior maxillary sinus. Now, one and a half years later, a localized CT scan at an oral surgeon's office confirms that the cyst has once again returned, even though it did not appear as a solid mass on my current panoramic x-ray like it did on the orthodontist's x-ray that diagnosed the cyst in the first place. This has come as a surprise, since I am not suffering any symptoms of swelling of the surrounding gums or oral discharge that I experienced before my first diagnosis.
     My oral surgeon strongly suggests that I have the 4x5 centimeter cyst removed using the LeFort 1 operation (separating the lower jaw from the upper jaw) to access the cyst and have the best chance of removing it completely. Unfortunately, I do not want to undergo such a radical procedure at this point in my life. Before this third diagnosis, I was informed in the past by this same surgeon that cryotherapy would be the next step should the cyst return. However, this oral surgeon, a different doctor from the one that performed my first two surgeries, now refuses to perform a standard procedure with cryotherapy as he claims he will be unable to reach every "nook and cranny" in which the cells might be hiding.
     Is the LeFort 1 operation really necessary at this point? Also, since the surgeon has informed me that the cyst is benign, what are the chances of it becoming cancerous?

Thank you.
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